Regency Endocrinology, Diabetes & Metabolism

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The Importance of Treating Diabetes Early!

When a person’s blood sugar level is higher than the normal one, he or she is said to have diabetes. Majority of diabetics are either Type-1 or Type-2 diabetes.

Type-1 diabetes (formerly known as juvenile diabetes) occurs when immune system in the body does not function properly and starts destroying insulin-producing cells in the pancreas needed to control blood sugar. It represents about 10 percent of the 180 million cases of diabetes globally. Patients with this type of diabetes typically need daily insulin to control their conditions.

The more common form of diabetes is Type-2 diabetes, which affects nearly 85 to 90 percent of diabetics. People with Type-2 diabetes have insulin resistance and relative insulin deficiency. It is usually caused by lifestyle factors like overweight or obesity, inactivity, hypertension (high blood pressure) and poor diet. Type-2 diabetics are twice as likely to suffer cardiovascular disease.

United States researchers from the University of Pittsburgh reported that Type-1 diabetics who can reduce the blood sugar to near-normal levels could cut their long-term risk of serious complications by half. Their results showed that early aggressive measures to control blood sugar worked better than conventional way of reducing blindness, kidney failure, and heart disease in people who had lived with Type-1 diabetes for at least 3 decades. The findings were published in the Archives of Internal Medicine on July 27, 2009.

The participants in the study were divided into 2 groups. The researchers compared overall rates of eye, kidney and cardiovascular complications in people with Type-1 diabetes.

One group was given insulin shots at least 3 times a day and their glucose readings were taken at least 4 times a day with the goal of achieving a long-term average blood sugar or A1c reading of 7, which is in the normal range.

The other group of patients was given conventional care, which was basically enough treatment to control diabetes symptoms. Patients in this group had an average A1c reading of 9.

All the patients were followed for 30 years with the 2 groups of patients staying on their treatment from 1983 to 1989. Those in the intensive group were found to have about half the rate of eye damage, comparing with those in the conventional care group. The intensive group also had lower rates of kidney failure and fewer cases of heart attack, stroke, chest pain or blocked arteries compared to those in the conventional care group.

Based on the results found in younger people with Type-1 diabetes, the researchers concluded that intensive glucose control may work best when started early.

The researchers also pointed out that advanced insulin formulations, insulin pumps, and continuous glucose monitors, and better control of blood pressure and heart disease have in fact greatly improved the outlook of people with Type-1 diabetes. The total market for treating both types of diabetes globally was US$25 billion in 2007.

Of course, there were other studies of intensive glucose control in older people with Type-2 diabetes. However, the results have been less conclusive and some have even shown higher risks of heart problems.